When Kutler, with the hospital's Internal Medicine/Infectious Disease Department, started the original center seven years ago, there were six patients that first week. Last year, 23,000 wounds were addressed by Kutler, registered nurse Kathleen Smith, the center's director, and a staff of 20.

"We needed more space and wanted more integration with the hospital proper," he says, pointing to its multispecialty approach that provides nutritional education to an obese patient, for example. "We hope to include more vascular and surgical services ... to be a true limb-saving center."

A component can be hyperbaric oxygen therapy (HBOT), which Kutler says is used for about 10-15 percent of patients.

"The air we breathe is 21 percent oxygen. In the hyperbaric chamber, it is 100 percent and under high pressure, as if you were 66 feet under water," he says, which ultimately increases the amount of oxygen and nutrients to the wound site, thereby promoting healing.

"We think it could be useful for more (conditions), but we have to go by the Medicare standards," he says of the 15 types of wounds available for HBOT, including diabetic sores that are not healing in six to eight weeks, bone and skin infections, traumatic wounds, burns, pressure sores and radiation damage following some cancer treatments.

"We had one patient with an acute injury to an ear," says Kutler. "HBOT helped salvage the ear after surgery."

There can be side effects, such as low blood sugar or increased blood pressure. Patients need to wear 100 percent cotton in the chamber, and contraband is monitored.

"There was a devastating outcome in Japan because of a cigarette lighter brought in by a patient," Kutler says.

So not only is each technician and physician mandated to meet all safety requirements, but also every one is certified. Kingston Hospital is one of only six hospitals in the state and one of 121 nationwide (out of more than 700 sites) to be accredited by the Undersea and Hyperbaric Medical Society.

HBOT traces its roots to data collected by Navy divers of World War II — and specifically how the "bends," or decompression sickness, caused by nitrogen in the blood could be reversed with oxygen under pressure.